Obstructed Inguinal Hernia with Maldescended Testis in an Infant: A Case Report

An inguinal hernia is a common congenital condition that can affect babies in their first year of life. This condition occurs when a segment of the intestines, omentum, or reproductive organs enters the scrotum or labia via an incompletely closed processus vaginalis. The main components of a hernia are typically the intestines and the ovaries or testicles. Immediate surgery is necessary for patients displaying an immobile dilated bowel loop (a potential indicator of strangulation) or reduced blood flow to the testicles/ ovaries. Here the authors present a case of a five-month-old male infant who presented with abdominal distension with painful swelling in the left groin, which was irreducible. The swelling was globular, smooth, firm, tender, and irreducible, with an elevated local temperature. The left testis could not be palpated in the left hemiscrotum. Ultrasound revealed an obstructed inguinal hernia in the left inguinoscrotal region, with aperistaltic intestinal loops, mild fluid collection, and an absent left testis. The patient was scheduled for urgent surgery. A 5 cm oblique incision was made; an 8×4 cm sac containing ileum was opened, and the viable bowel was reduced. The sac was then ligated and excised, and a herniotomy was performed. The left testis was found to be viable and repositioned into the scrotum, followed by orchidopexy. Inguinal hernia in an infant can rapidly progress to strangulation; hence, early recognition and prompt surgical management are crucial to prevent life-threatening complications and preserve gonadal viability.